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Tocilizumab (Actemra) is a rheumatoid arthritis antibody that has become the rescue drug for cytokine release syndrome, the fever and blood-pressure crash that CAR-T cells and bispecific antibodies can trigger. Every CAR-T centre must have it on hand.
Tocilizumab was approved by the FDA in 2010 for rheumatoid arthritis and in August 2017, on the same day as the first CAR-T approval (tisagenlecleucel), for severe or life-threatening CAR-T-cell-induced cytokine release syndrome in patients aged 2 and over, on a retrospective analysis of pooled CAR-T trials in which about two-thirds of patients had CRS resolve within 14 days of one or two doses. The CAR-T REMS programmes require two doses to be available on site for every patient, and it is used with the same logic for CRS from bispecific T-cell engagers, though not on label. Because it does not cross the blood-brain barrier it does not treat neurotoxicity (ICANS), for which corticosteroids are used. The EU authorised RoActemra in 2009; biosimilars (Tofidence, Tyenne) followed in 2023 to 2024. Serious infection carries a boxed warning in chronic use.
Backbone ribbon from PDB 8J6F. RCSB PDB 8J6F. The ribbon widens where the chain is folded into a regular pattern and narrows where it is a loose loop.
Binds soluble and membrane-bound IL-6 receptors and blocks IL-6 signalling, the central mediator of cytokine release syndrome after T-cell-redirecting therapy. Connects to Interleukin-6 and IL-6 receptor.
1.Tocilizumab binds Interleukin-6 and IL-6 receptor.
| Region | Year | Indication |
|---|---|---|
| US | 2010 | Rheumatoid arthritis (first approval) |
| US | 2017 | Severe or life-threatening CAR-T-cell-induced cytokine release syndrome, age 2 and over |
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Query for this drug: (TITLE:"Tocilizumab" OR ABSTRACT:"Tocilizumab" OR TITLE:"Actemra" OR ABSTRACT:"Actemra" OR TITLE:"RoActemra" OR ABSTRACT:"RoActemra" OR TITLE:"Tofidence" OR ABSTRACT:"Tofidence" OR TITLE:"Tyenne" OR ABSTRACT:"Tyenne") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Tocilizumab, not a curated reading list.
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Shares Diffuse large B-cell lymphoma, Non-Hodgkin lymphoma (all types) and the tag supportive.
Shares Diffuse large B-cell lymphoma, Non-Hodgkin lymphoma (all types) and the tag supportive.
Shares Diffuse large B-cell lymphoma and the tag supportive.
Shares Diffuse large B-cell lymphoma and the tag supportive.
Shares Monoclonal antibodies and the tag supportive.